HLC Newsletter

More Than 140 Patient, Provider, Retiree Organizations Urge Congress to Erect Safeguards Around Medicare, Medicaid Demonstration Projects

Letter to Lawmakers Endorses Bipartisan House Legislation That Would Limit Scope, Duration of Center for Medicare and Medicaid Innovation Tests

WASHINGTON – In a letter to members of Congress, more than 140 organizations representing patients, healthcare providers and retirees are urging passage of bipartisan legislation that would institute new safeguards around demonstration projects administered by the Center for Medicare and Medicaid Innovation (CMMI), saying that “too many CMMI models endanger patient access to healthcare providers and medically necessary treatments and create unnecessary obstacles for vulnerable patients.”

The organizations are endorsing the “Strengthening Innovation in Medicare and Medicaid Act” (H.R. 5741), introduced last month by Representatives Terri Sewell (D-AL) and Adrian Smith (R-NE) that would, among other provisions:

• Institute a formalized process for advance public notice and opportunity for input from beneficiaries and other stakeholders before testing or expanding a demonstration.

• Establish continuous real-time monitoring of the effects of new models to immediately address any adverse impacts.

• Restrict the number of participants in demonstration projects to the number necessary to gain a statistically-valid sample. The groups wrote, “Several on-going CMMI Phase I models are national in scope, affecting a large number of beneficiaries and providers before the demonstration’s consequences have been fully evaluated.”

• Limit testing of new payment and delivery models to five years in duration. The organizations’ letter said this would ensure “beneficiaries will no longer be subjected to potentially harmful models for sustained periods of time.”

• Reaffirm Congress’s role in the expansion of CMMI models by creating an expedited process for Congress to disapprove of a proposed expansion.
In the letter, the organizations wrote that the bipartisan legislation “provides safeguards for CMMI to ensure CMMI demonstrations are patient-focused and benefit beneficiaries. In the long run, improving healthcare delivery and quality is the best way to achieve sustainable cost savings.”